Understanding your vision benefits allows you to take advantage of the coverage provided by your insurance plan.
Coverage usually includes the cost of contact lenses, glasses, eye exams, and some other services. Exactly what’s covered will depend on your provider and the details of your insurance plan.
At Unger Eye Care in Troy we accept several different insurance plans. Be sure to book an appointment with us!
What to Understand About Vision Benefits
#1 Understand the Difference Between Medical and Vision Insurance
Vision insurance plans typically cover regular eye exams but not specialized testing or treatment for eye diseases. In contrast, medical health insurance usually doesn't cover eye exams, glasses, or contact lenses, but does cover testing and treatment for eye diseases and some other eye conditions. This is the prime reason many people get a separate vision insurance policy just for their eyes.
All qualified health plans under the auspices of the Affordable Care Act (ACA) are required to cover eye diseases and eye care for children.
Even if you have vision or health insurance, you may still have to pay some of the costs yourself, like co-pays (which are due at the time of the service being rendered), deductibles, or a percentage of the total cost before getting glasses or contacts.
#2 Medical Concerns and Vision Insurance
If you have a medical eye problem like glaucoma, dry eye, or macular degeneration, it will be treated first or concurrently with your vision problem. Medical insurance usually separates an eye exam into two parts: the comprehensive exam and the refraction (which decides your glasses or contact lens prescription).
Vision insurance typically covers both the routine exam and refraction, while medical insurance only covers the exam. If you only have medical insurance, you'll probably have to pay for the prescription yourself.
If your eye doctor finds that you have an eye disease or abnormality, they will give you more information about it and let you know about any extra tests you may need.
With this information in hand, you can ask your insurance company whether it will cover these tests and whether you’ll need to pay deductible or other costs beyond your coverage.
One excellent way to cover out-of-pocket expenses is through a tax-saving Flexible Spending Account (FSA) through your workplace.
#3 Use it Or Lose It
FSA’s and some vision insurance plans require that you use or lose your benefits before the end of the year. So be sure to make the most of this year’s benefits.
#4 Come Prepared
The typical process for using vision benefits includes scheduling an eye exam with your eye doctor and presenting your insurance card at the time of your appointment. At this point, you may be requested to pay a copayment before services are rendered.
Depending on your provider, you may also be required to submit a form that will allow them to reimburse you for the cost of your eye care, especially if you’re visiting an out-of-network provider.
Prior to an appointment with your eye doctor, it’s always a good idea to ask your insurance provider exactly which services and eyewear are covered, and whether your spouse and children are covered as well.
Use Your Vision Benefits at an Eye Care Center in Troy
By understanding your vision benefits, you’ll be able to make informed decisions when it comes to your eye care. By knowing the details of your coverage, you can maximize your vision benefits in the most effective way possible.
Book a comprehensive eye exam with Unger Eye Care in Troy. We’re here for all of your eye care needs.